Posted By CCF Cardio MD-SGM on March 24, 1998 at 19:41:24:
In Reply to: vena cava aneurysm: update and image posted by mariette on March 21, 1998 at 15:15:15:
: Dear Sir!
Thanks very much for your information regarding the recurrent DVT and PEs. Because the issue of the vena cava diameter increase I attach the image of the x-ray (phlebogram). I hope you can help me with this matter. Could this be an explanation of the recurrent DVTs and PEs? Mind you: despite the coumadin and INR within range it keeps happening... I would love to come over to your clinic to be evaluated again, but there are a few thousand miles between us...
Thanks very much for your time and reply again!
The image could be found at http://www.marge.com/x-ray/x-ray.htm
The Xray does appear to show an area of dilation, or aneurysm, involving the inferior vena cava (IVC). There are many possible explanations for this, although I believe that knowing the specific cause won't change the management. If you've suffered recurrent PE's despite adequate anticoagulation with Warfarin (Coumadin), it is time to consider placing a filter in the IVC to prevent future PE's. This needs to be discussed with a specialist.
As you know, this forum is not intended to diagnose or manage the particulars of a specific patient's course. Instead, we try to give general recommendations that offer some educational value to readers who may consult this page. Regrettably, I believe that our ability to advise you on this issue has been exceeded. As such , it would be wise to consult with experienced physicians, especially at a large hospital or academic medical center in your area.
Best of luck.
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